Malaysia

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Focus: HIV, Tuberculosis and Viral Hepatitis Prevention and Treatment in Criminal Justice and Community Health Settings

Affiliation: University of Malaya; Yale Schools of Public Health and Medicine

Contacts: Dr. Frederick Altice, MD, MA frederick.altice@yale.edu; Adeeba Kamarulzaman, M.D. adeeba@um.edu.my

Projects: The training site will be the University of Malaya and the Centre of Excellence on Research in AIDS (CERiA), which has ongoing relationships with a number of different departments and schools within the university, relationships with Malaysian government, including the Prisons Department, Ministry of Health and the Anti-Drug Agency.  The site also has an ongoing relationship with the Malaysian AIDS Council, the country’s largest AIDS Service NGO that oversee the provision of HIV prevention and treatment for the country.  Drs. Altice and Kamarulzaman, now the University of Malaysia’s Dean of the Medical School, have collaborated together continuously since 2005 and these have served as training sites for numerous pre- and post-doctoral fellows. Drs. Altice and Kamarulzaman have trained a number of pre- and post-doctoral fellows in both medicine and public health and collectively they have been involved in rolling out the first methadone maintenance treatment in the country as HIV prevention.  They were also the first to become involved in criminal justice research and have been involved in both prison research, but also in examining alternatives to health and rehabilitation by comparing community models of care to compulsory drug detention centers. There are opportunities to work with drug use, HIV risk, tuberculosis, primary and secondary HIV prevention and intervention research within the “fisherman” industry through multiple existing collaborations.  The team has continued to train individuals from Malaysia, the United States and elsewhere on issues related to urban health, HIV, tuberculosis, health services research and addiction medicine.  Drs. Altice and Kamarulzaman collaborate on one large R01 grant from the National Institutes on Drug Abuse and several others from the United Nations and World Bank.  We are currently conducting trials of both behavioral interventions and medication-assisted therapies for criminal justice populations transitioning from prison to the community as well as studies of TB in community and criminal justice settings. New studies underway are examining risk among female sex workers. Additional studies include mathematical modeling and cost-effectiveness analysis. On-going projects for fellows include:

  1. A NIDA-funded research program designed adapt an evidence-based intervention, the Holistic Health Recovery Program (HHRP) – in collaboration with Michael Copenhaver from the University of Connecticut – and to compare it to methadone maintenance treatment among soon to be released prisoners in Malaysia who are transitioning to the community. Additional findings include our identification of increased prevalence of tuberculosis and potential health outcomes.   
  2. A World Bank-funded project that compares compulsory drug detention programs with community based methadone maintenance as an alternative to forced detention.  Cost-effectiveness, mathematical modeling and health services outcomes are being examined. 
  3. Studies of active and latent tuberculosis among prisoners, community members and individuals entering substance abuse treatment programs.

Webpages for sites and research programs:
Yale:    http://medicine.yale.edu/intmed/people/frederick_altice-3.profile
            http://cira.yale.edu/people/frederick-l-altice-md